Acute trauma and repetitive muscle use can cause damage to muscular tissues resulting in inflammation and prolonged contraction. The combination of inflammation and contraction results in a restriction of microcirculation. The restriction lowers the amount of oxygenated blood flow to the site and removal of waste. As a result, the site may become hypoxic from the lack of oxygen, resulting in formation of scar tissue around the injured muscles and connective tissue. Over time, such scar tissue often forms a myofascial trigger point. If not treated properly, myofascial trigger points can limit muscle function, causing compression and irritation of nerves with resulting biomechanical disturbances in gait and function. The disturbances manifest themselves in a symptomatic decrease range of motion and pain.
There are a numerous known techniques used to improve the range of motion and reduce the pain associated with a trigger point. TDN is one of the techniques used to treat myofascial trigger points that are not manually palpable. During TDN, a thin filiform needle is inserted directly into the myofascial trigger point. Insertion of the needle results in a stimulation of the underlying muscle and tissue. The stimulation in many cases releases and inactivates the myofascial trigger point. This stimulation is also known to cause what is known as a Local Twitch Response (“LTR”). The LTR is an involuntary spinal cord reflex that causes a muscle to visibly contract. It can be diagnosed immediately through tactile feedback through a filiform needle. An LTR is critically valuable to the TDN process because it allows recognition of the existence and location of a myofascial trigger point. However, it is often times difficult to achieve an LTR without repeated needle use, which can cause unnecessary pain and muscle damage.
In the prior art, TDN is typically performed with the patient fixed and relaxed position and with no movement of the patient whatsoever during treatment. It is thought that motionless application of TDN prevents or lessens muscle damage during treatment.
The prior art discloses various methods of acupuncture intended to improve a muscle's range of motion and relieve pain, but none are directed at targeting myofascial trigger points using TDN and none require inserting needles at specific angles and specific needle movement protocols as a patient executes a specific repetitive body motion in order to induce LTR.
For example, U.S. Patent Publication No. 2014/0128899 to Shin discloses a method of treatment combining a motion style treatment with acupuncture. The method includes applying a “chuna” treatment to relax injured muscles or ligaments, then applying needles to acupuncture points while a patient slowly walks with the help of assistants. Once the patient walks without pain, treatment is terminated. The needles are not manipulated during the procedure. Trigger points are not targeted.
U.S. Patent Publication No. 2006/0095087 to Shin discloses a method of treatment of stiff muscles, ligaments, and nerves that combines a motion style treatment with acupuncture. The treatment comprises using “tui na” therapy to relax muscles. During treatment an acupuncture needle is inserted into a muscle at an “acupoint.” The muscle is then moved to maximize circulation of “qi.” The acupoints are not myofascial trigger points, but rather said to correspond to nerve pathways in the body.
U.S. Pat. No. 6,022,368 to Gavronsky discloses an apparatus for treatment using acupuncture. The apparatus consists of a convex enclosure that includes an acupuncture needle. The enclosure is sealed with adhesive tape. In use, the needle is inserted into the patient at the acupuncture site by puncturing the tape. Then, as the patient performs movement, if the patient does not feel an acupuncture sensation from the needle, a downward pressure is applied to the needle by flattening the enclosure.
It has been recognized by the inventor that TDN is rarely successful unless an LTR is induced. Hence, there is a need for a TDN method to ensure that an LTR will be induced to treat myofascial trigger points that does not require excessive treatment. There is also a need for a TDN method that combines modern patient movement patterns with planned and controlled needle movement protocols at a myofascial trigger point to optimize TDN treatment to maximize therapeutic effect.